Provider Demographics
NPI:1962815597
Name:WHEELER, SARAH (MSW, LCASA, LCSWA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MSW, LCASA, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 EASTGATE DR STE E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4283
Mailing Address - Country:US
Mailing Address - Phone:252-702-2410
Mailing Address - Fax:
Practice Address - Street 1:2050 EASTGATE DR STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4283
Practice Address - Country:US
Practice Address - Phone:252-702-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-20599101YA0400X
NCP0089101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)